If John McCain is elected he will be the oldest U.S President to begin his first term. At 72 years of age, he will be 3 years older than Ronald Reagan was in January 1981.
While this fact is often joked about, the media has not made a systematic exploration of what this means. This paper puts the incidence of Alzheimer's in someone as old as John McCain would be by the end of his first term at around 3.3%. Another study shows that about 22% of people over 71 suffer from cognitive impairment without dementia. Add these numbers together, and statistically there is a better than one if four chance that John McCain will suffer some sort of significant mental decay over the next four years. There is already plenty of anecdotal evidence that McCain's powers might already be diminishing:
Of course, there are other problems associated with advancing age: stamina diminishes and susceptibility to disease and injury increases. While McCain is a very peppy septuagenerian, he has suffered from melanoma, a form of skin cancer, and he has a variety of injuries from his Vietnamese captivity that could become chronic pain problems.
The Presidency is a tough job for even a young, healthy person. Famously, we have seen how the office ages its occupants. Can John McCain afford to hit the fast forward button? Or is it ageist to even ask?
I would argue that senior citizens should be offered the opportunity to do the same jobs younger Americans do. The Presidency, however, is a different matter because it is a job of unique and paramount importance, and because it entails a 4-year term. Many Fortune 500 companies force their CEOs to retire at 65, and I suppose they have good business reasons to, but if a CEO's intellectual powers are lost the board could fire him. We'd likely be stuck with a diminished leader. Under Amendment 25, power can be transferred to the Vice President only with the express consent of the President, or if the President is "unable to discharge" his duties, then with a majority vote from the cabinet. It seems quite plausible that a spirited man like McCain might hold on to office, despite the decay of his powers, and it seems implausible that a cabinet of the President's most ardent loyalists would take this power away from him.
So why won't the media discuss this legitimate issue? They don't think it's polite.
They need to be prodded. Once the issue is in the ether, the media will have an excuse to be impolite, which they love to do because it is provocative and good for ratings. Medical experts will be called on to testify on every cable news show, the newsmagazines will pen long thumbsuckers, and people will think about their own experiences with people over 70 and make up their own minds. The Obama campaign would have to be crazy not to bring this up, and I think they will. The trick is to inject the question into the national debate without alienating older voters. I would suggest that Howard Dean would be the perfect surrogate, both because of his medical background and because he's not running for anything. Obama can then issue a soft denial like "this is an issue that voters have to decide upon, not me, but John McCain certainly seems like an energetic guy."